Table 4.
Patient Level Multivariate Results for Severe Acute Respiratory Syndrome Coronavirus 2 Impact on Antimicrobial Resistance Rates Overall and by Community and Hospital Onset for Those With Gram-Negative/Gram-Positive Pathogensa
| Characteristic | Overall Model (N = 514 519) |
Community Onset (n = 410 125) |
Hospital Onset (n = 104 394) |
|||
|---|---|---|---|---|---|---|
| OR of Having AMR (95% CI) | P Value | OR of Having AMR (95% CI) | P Value | OR of Having AMR (95% CI) | P Value | |
| SARS-CoV-2 time (ref: pre–SARS-CoV-2) | ||||||
| SARS-CoV-2 period | 0.942 (.929–.954) | <.001 | 0.939 (.925–.953) | <.001 | 0.982 (.902–1.068) | .667 |
| SARS-CoV-2 status (ref: pre–SARS-CoV-2) | ||||||
| Positive | 1.156 (1.008–1.325) | .038 | 0.971 (.945–1.017) | .425 | 1.250 (1.168–1.364) | <.001 |
| Negative | .946 (.930–.963) | <.001 | 0.947 (.929–.965) | .001 | 0.945 (.908–.984) | .005 |
| Not tested | 0.936 (.923–.950) | <.001 | 0.934 (.919–.950) | <.001 | 0.944 (.914–.976) | .001 |
| Age | 1.000 (.999–1.001) | .056 | 1.001 (.999–1.001) | .484 | 1.002 (1.002–1.003) | <.001 |
| Male sex | 1.128 (1.114–1.141) | <.001 | 1.159 (1.143–1.175) | <.001 | 1.026 (.999–1.053) | .056 |
| Antibiotic use per day | 1.034 (1.033–1.035) | <.001 | 1.029 (1.027–1.032) | <.001 | 1.038 (1.036–1.040) | <.001 |
| GN/GP (ref: GN) | ||||||
| GP | 1.240 (1.223–1.257) | <.001 | 1.224 (1.205–1.244) | <.001 | 1.287 (1.250–1.326) | <.001 |
| GN and GP | 1.552 (1.512–1.593) | <.001 | 1.584 (1.537–1.633) | <.001 | 1.473 (1.399–1.551) | <.001 |
| IET | 2.142 (2.103–2.182) | <.001 | 2.199 (2.153–2.245) | <.001 | 1.922 (1.844–2.002) | <.001 |
| Prior admission | 1.513 (1.492–1.534) | <.001 | 1.514 (1.491–1.537) | <.001 | 1.501 (1.454–1.549) | <.001 |
| Underlying conditions | 1.069 (1.053–1.086) | <.001 | 1.064 (1.046–1.082) | <.001 | 1.100 (1.054–1.139) | <.001 |
| Ventilated | 1.000 (.971–1.029) | .972 | 1.018 (.977–1.061) | .385 | 1.007 (.965–1.051) | .737 |
| ICU admission | 1.038 (1.021–1.056) | <.001 | 1.071 (1.051–1.092) | <.001 | 1.055 (1.022–1.085) | .004 |
Abbreviations: AMR, antimicrobial resistance; CI, confidence interval; IET, inadequate empiric therapy; GN, gram-negative; GP, gram-positive; ICU, intensive care unit; OR, odds ratio; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
Model comparing pre–SARS-CoV-2 versus SARS-CoV-2 periods run separately from model comparing SARS-CoV-2 testing status to pre–SARS-CoV-2. Covariates for the SARS-CoV-2 testing status models are shown; covariates did not significantly vary by model. All models also control for hospital demographics: urban/rural, teaching status, bed size, and region.